Fornari F, Civardi G, Buscarini E, Cavanna L, Imberti D, Rossi S, Sbolli G, Di Stasi M, Buscarini L
I Divisione di Medicina, Servizio di Gastroenterologia, Ospedale di Piacenza, Italy.
Dig Dis Sci. 1990 Nov;35(11):1403-8. doi: 10.1007/BF01536748.
An ultrasonographic study about the prevalence of cholelithiasis was performed in 410 cirrhotic patients and in 414 controls matched for age and sex. Gallstone disease was found more often in cirrhotic patients (31.9%) than in controls (20.7%) (P less than 0.001). The female-to-male ratio of gallstones prevalence in cirrhotic patients approached to 1:1. Gallstone disease in cirrhotic patients vs controls was significantly higher (30.2% vs 16.5%) (P less than 0.001) in males only. No difference was found, for gallstone disease prevalence in cirrhosis of different etiology. The prevalence of cholelithiasis increased from Child's A to Child's C with a significant trend (P less than 0.001); this difference was significant in males (12.3% vs 40.5%) (P less than 0.001) but not in females. This study shows that cirrhosis represents a risk factor for the development of cholelithiasis in males. We suggest that high levels of estrogens could play a role in these patients, by an impairment of gallbladder emptying similar to that observed in pregnant women.
对410例肝硬化患者和414例年龄及性别相匹配的对照者进行了一项关于胆结石患病率的超声研究。发现肝硬化患者中胆结石疾病的发生率（31.9%）高于对照组（20.7%）（P<0.001）。肝硬化患者中胆结石患病率的女性与男性比例接近1:1。仅在男性中，肝硬化患者与对照组相比，胆结石疾病的发生率显著更高（30.2%对16.5%）（P<0.001）。对于不同病因肝硬化患者的胆结石疾病患病率，未发现差异。胆结石的患病率从Child A级到Child C级呈显著上升趋势（P<0.001）；这种差异在男性中显著（12.3%对40.5%）（P<0.001），但在女性中不显著。这项研究表明，肝硬化是男性发生胆结石的一个危险因素。我们认为，高水平的雌激素可能通过类似于孕妇中观察到的胆囊排空受损，在这些患者中发挥作用。
